DocketNumber: I.C. NO. 033675
Judges: <center> OPINION AND AWARD for the Full Commission by RENE C. RIGGSBEE, Commissioner, and DISSENT by THOMAS J. BOLCH, Commissioner, N.C. Industrial Commission.</center>
Filed Date: 11/15/2002
Status: Precedential
Modified Date: 7/6/2016
Under appropriate circumstances, work-related depression or other mental illness may be a compensable occupational disease. Pitillo v.N.C. Dept. of Envtl. Health and Natural Resources,
A disease is `characteristic' of a profession when there is a recognizable link between the nature of the job and an increased risk of contracting the disease in question. Keller v. City of Wilmington PoliceDept.,
In the present case before the Commission, the majority has found in its Opinion and Award, that plaintiff's diagnosed depression, dysthymia, insomnia, and other psychological problems were not "characteristic of" and "peculiar to" plaintiff's employment with defendant as a nurse. Rather, the majority erred in finding plaintiff's condition to be an ordinary disease of life to which the public, not so employed, is equally exposed. The majority has relied upon Woody v. Thomasville Upholstery,
The plaintiff before this Commission did experience many of the same work-related stressors that the general public is exposed to outside the workplace in everyday life, however much of her stressors exceeded what could reasonably be deemed as normal, day-to-day stressors and were indeed characteristic of and peculiar to plaintiff's employment as a nurse. Contemporary with the advancement of plaintiff's depression, she experienced severe bouts of insomnia as a consequence of the rotating shifts that she was required to work. Plaintiff's husband, Milton Lewis, and plaintiff's psychiatrist, Nancy L. Roman, M.D., both testified that plaintiff was required to work erratic shifts with constantly changing hours. Tr. at p. 18; Depo. of Dr. Roman at p. 25. When plaintiff made requests that defendant work out a better schedule for her because of her insomnia and resulting depression, her requests were not met. Depo. of Dr. Roman at p. 26. Such erratic shift work is not typical of the general public. Due to the 24-hour operations of a hospital and its need for around-the-clock nursing support, such conditions can only be described as characteristic of and peculiar to the field of nursing.
In addition to plaintiff's depression as a consequence of her insomnia, a great source of plaintiff's depression was caused by her proximity to chronically ill and dying patients. From 1973 through the early 1990's, plaintiff's duty as a registered nurse employed by defendant largely involved working with diabetic patients, teaching them how to care for themselves and how to manage their disease effectively. Tr. at p. 10. Her role as a nurse was to help people to get well through education and training. Id. However, during the early 1990's defendant experienced a reorganization of its hospitals. Tr. at p. 9. In order to maintain her employment with defendant, plaintiff was required to care for terminally ill patients, many of whom were inflicted with AIDS, terminal cancer, and end-stage renal disease. Tr. at pp. 10 51; Depo. of Dr. Roman at p. 36. Plaintiff grew close to many of her patients, only to have them die while in her care, which proved to be very difficult for plaintiff. Tr. at p. 10. Plaintiff soon found that defendant provided no support structure for her to fall back upon to help her and other nurses to deal with the grief experienced from losing patients. Tr. at p. 11; Depo. of Dr. Roman at p. 37. This factor caused plaintiff a good deal of stress and contributed to the development of her depression and dysthymia. Depo. of Dr. Roman at p. 67. It cannot be said that the general public is equally exposed outside the workplace to terminally ill and dying patients in everyday life. Such occurrences are undoubtedly characteristic of and peculiar to the field of nursing.
Quite similarly, the general public is not equally exposed to the awesome burden of facing life and death situations during a routine day at work. While doing post-operative work for defendant, plaintiff was made charge nurse on many of her shifts, meaning it was her responsibility to delegate duties to other nurses on her shift. Tr. at pp. 14
This Commission has seen fit to recognize causal links between certain occupations and an increased risk of contracting an occupational disease. In Pulley v. City of Durham,
Even if the majority fails to recognize a causal link between nursing and an increased risk of contracting depression, plaintiff has met her burden of proving that her occupational exposure to stress was such a significant factor in the development of her depression and dysthymia that without it the diseases' development would not have been to such an extent that it caused the physical disability that resulted in plaintiff's incapacity for work. See Perry v. Burlington Industries,Inc.,
Despite the evidence of plaintiff's occupational disease and its causal relationship to her employment with defendant, the majority has stated that plaintiff's depressive disorder is more likely a consequence of the recent deaths of her father and half-sister. There is no question that such events contributed to plaintiff's depression; however, both Mr. Lewis and Dr. Roman testified that plaintiff's depression preceded these deaths. Tr. at p. 7; Depo. of Dr. Roman at p. 27. Additionally, they both testified that after these deaths, plaintiff looked forward to returning to work and was able to focus on her work despite her grief. Tr. at p. 30; Depo. of Dr. Roman at p. 24. It cannot be said that plaintiff's grief did not contribute to her depression, yet it is clear from Dr. Roman's testimony that absent her work stressor's, plaintiff would not have progressed to a severe depressive state. Depo. of Dr. Roman at p. 67. Moreover, N.C. Gen. Stat. §
Finally, the majority's Opinion and Award ignores the fact that normal work stressors, common to the general public, can reach a threshold at which they cause occupational injury, as in the case before us. Perhaps the Commission should consider the approach of other jurisdictions, in particularly the State of Wisconsin. In attempting to find an effective means of evaluating an employee's claim of mental injury without opening a floodgate of fraudulent claims, the Wisconsin Court of Appeals, inSchool Dist. No. 1 v. DILHR,
The majority has erred in failing to award compensation to plaintiff for her development of depression and dysthymia, each an occupational disease, as a result of extreme work-related stress experienced during her employment with defendant. In doing so, the majority creates a presumption that any type of mental injury causally related to day-to-day work-related stressors cannot be compensable no matter how great or severe that stressor may be. The majority fails to consider that a normal day-to-day stressor can exceed a threshold in which it surpasses the level of normal work-related stress experienced by the general public to become an "unusual" stressor and the cause of an occupational mental injury. Moreover, the majority has failed to recognize a causal link between nursing and an increased risk of contracting depression despite the evidence of record.
For these reasons, I respectfully dissent from the majority's Opinion and Award.
S/_____________ THOMAS J. BOLCH COMMISSIONER
Beam v. Kerlee , 342 N.C. 651 ( 1996 )
Booker v. Duke Medical Center , 297 N.C. 458 ( 1979 )
Jordan v. Central Piedmont Community College , 124 N.C. App. 112 ( 1996 )
Baker v. City of Sanford , 120 N.C. App. 783 ( 1995 )
Rutledge v. Tultex Corp./Kings Yarn , 308 N.C. 85 ( 1983 )
Woody v. Thomasville Upholstery Inc. , 355 N.C. 483 ( 2002 )
Woody v. THOMASVILLE UPHOLSTERY EMPLOYER , 146 N.C. App. 187 ( 2001 )
Pulley v. City of Durham , 121 N.C. App. 688 ( 1996 )
Humphries v. Cone Mills Corp. , 52 N.C. App. 612 ( 1981 )
United Parcel Service, Inc. v. Lust , 208 Wis. 2d 306 ( 1997 )
Perry v. Burlington Industries, Inc. , 80 N.C. App. 650 ( 1986 )
Pitillo v. NC DEPT. OF ENV. HEALTH , 566 S.E.2d 807 ( 2002 )
School District No. 1 v. Department of Industry, Labor & ... , 62 Wis. 2d 370 ( 1974 )
Harvey v. Raleigh Police Department , 85 N.C. App. 540 ( 1987 )